Individual provider Active NPI

Julia Katherina McKeown, PA-C

  • Physician Assistant
  • Eugene, OR
National Provider Identifier
1760012165
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA207072 Issued in OR
Practice address
598 E 13TH Ave
Eugene, OR 97401-4783
Phone
(541) 636-3473
NPI assigned
Jan 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA207072 OR Primary

Addresses

Primary practice location

598 E 13TH Ave
Eugene, OR 97401-4783

Mailing address

598 E 13TH Ave
Eugene, OR 97401-4783
Phone (541) 636-3473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201003086 OR Practitioner - Physician Assistant 8729418181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

1800 Coburg Rd
Eugene, OR 97401-4995
Phone (541) 345-8760

2710 Willamette St
Eugene, OR 97405-3238
Phone (541) 735-3161

5781 Main St
Springfield, OR 97478-5426
Phone (541) 654-0282

598 E 13TH Ave
Eugene, OR 97401-4783
Phone (541) 636-3473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA207072ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Dec 13, 2021 Accepting new patients
Icco, LLC Past Accepting new patients
Family Choice Urgent Care LLC Past Accepting new patients
Icco, LLC Past Accepting new patients

Locations

108 NW Sisemore St
Ste 120
Bend, OR 97703
Phone (541) 213-2133

1445 Gateway Blvd
Cottage Grove, OR 97424
Phone (541) 767-3023

4040 W 11th Ave
Ste B
Eugene, OR 97402
Phone (458) 215-2311

2710 Willamette St
Eugene, OR 97405
Phone (541) 735-3161

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1800 Coburg Rd
Eugene, OR 97401
Phone (541) 342-1632

355 W 3rd Ave
Junction City, OR 97448
Phone (541) 998-2468

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

1755 SW Baker St
McMinnville, OR 97128
Phone (971) 900-4522

1740 NW Goetz St
Roseburg, OR 97471
Phone (541) 672-4789

5781 Main St
Springfield, OR 97478
Phone (541) 284-1694

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1760012165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 E 13TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014783",
            "telephone_number": "541-636-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 E 13TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014783",
            "telephone_number": "541-636-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEOWN",
        "first_name": "JULIA",
        "middle_name": "KATHERINA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA207072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.